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08/19/2009 WED 15:08 FAX 402 471 4429 UCC SSCRBTARY OF STATE ~yy Hall <br />X003/003 <br />~ 519]. <br />0 Department of the Treasury -Internal Revenue Service <br />Fay 668 (~(`) ......Notice of Federal Tax Lien N. ~__ ~ ~._._ .. _ _ <br />lRev. Fabruarv 20041 <br /> <br />Area: Serial Number F <br />SMALL BU9IlVESB/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 572152609 <br />As provided by section b3Z t, 6322, and 6323 of the Internal Revenue <br />Code, we are gluing a notice that taxes (including Interest and penalties) 9908805®58-7 Pqs: 1 <br />have been assessed against the following-named taxpayer. We have made riled m8R19/2509 11:11 art <br />a demand far payment of this liability, but it remains anpaid. Therefore, <br />there is a lien in favor of the llnlted States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, Interest, and costs that may aurae. 2 ~ ~ 9 Q s <br />Name of Taxpayer LARRY J HOLDER <br />Residence 515 W 16TH ST <br />GRAND ISLAND, NE 68801-3511 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />an the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br /> Tax Period Date of Last Day far Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Reflling of Assessment <br />a b c) (d) e <br />1040 12/31/2006 XXX-XX-5695 07/20/2009 08/19/20.9 3900.98 <br />1040 12/31/2007 XXX-XX-5695 07/13/2009 08/12/2019 .876.76 <br />1040 12/31/2008 XXX-XX-5695 07/20/2009 08/19/2019 2042.53 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total $ 6820.27 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at CHICAGO, TL <br />an this, <br />the 11th day of August 2009 <br />Signature A Title <br />REVENUE OFFICER 24-10-1720 <br />for DANIELLE L MUELLER (402) 473-4675 x2912 <br />(NOTES Certif(cate of officer authorized by law to take acknowledgmerrt is not essential to the validity of Notice of Federal Tax Ilan <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form bb8(1Q(c) iRev. 2-2004) <br />_ - , . Part 1 -Kept sy Recordir~>£ Ot~ce CA7. NQ. Bp,Q26~C.,,.,,-„ <br />